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Registration Forms
CHILD’S INFORMATION
Child’s full name_____________________________________________ Date of birth_______________________________________________ Child’s home address_________________________________________ City, State, Zip_____________________________________________ Child’s home phone number_____________________________________
PARENT OR GUARDIAN INFORMATION
Father’s name______________________________phone____________ Father’s address____________________________________________ Father’s occupation and place of employment________________________ _________________________________________phone____________ Mother’s name______________________________________________ Mother’s address____________________________________________ Mother’s occupation and place of employment_______________________ _________________________________________phone____________
FAMILY INFORMATION
Brothers and/or sisters (please indicate ages and whether they live with the child)_____________________________________________________ Please list any other persons living with the child and their relationship (if any) to the child___________________________________________________
PICK-UP
Persons authorized to pick up child_________________________________ __________________________________________________________
Persons NOT authorized to pick up child_____________________________
__________________________________________________________
PERSONAL HISTORY
Is child right or left handed?___________________________________ Has child had a previous group or preschool experience?________________ If so, when and when?_________________________________________ __________________________________________________________
Does child have any allergies?___________________________________ Are there any medical problems of which we should be aware of?_________ _________________________________________________________ What words does child use for toileting?___________________________ _________________________________________________________ Does child have any bowel or bladder irregularities?__________________ _________________________________________________________ Are there any special food or eating instructions?____________________ _________________________________________________________ Are there any special sleeping or napping instructions?________________ _________________________________________________________ Any additional information such as discipline, child’s communication, comforting, and so on?__________________________________________________ ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Child’s full name_____________________________________________ Date of birth_______________________________________________ Child’s home address_________________________________________ City, State, Zip_____________________________________________ Child’s home phone number_____________________________________
PARENT OR GUARDIAN INFORMATION
Father’s name______________________________phone____________ Father’s address____________________________________________ Father’s occupation and place of employment________________________ _________________________________________phone____________ Mother’s name______________________________________________ Mother’s address____________________________________________ Mother’s occupation and place of employment_______________________ _________________________________________phone____________
FAMILY INFORMATION
Brothers and/or sisters (please indicate ages and whether they live with the child)_____________________________________________________ Please list any other persons living with the child and their relationship (if any) to the child___________________________________________________
PICK-UP
Persons authorized to pick up child_________________________________ __________________________________________________________
Persons NOT authorized to pick up child_____________________________
__________________________________________________________
PERSONAL HISTORY
Is child right or left handed?___________________________________ Has child had a previous group or preschool experience?________________ If so, when and when?_________________________________________ __________________________________________________________
Does child have any allergies?___________________________________ Are there any medical problems of which we should be aware of?_________ _________________________________________________________ What words does child use for toileting?___________________________ _________________________________________________________ Does child have any bowel or bladder irregularities?__________________ _________________________________________________________ Are there any special food or eating instructions?____________________ _________________________________________________________ Are there any special sleeping or napping instructions?________________ _________________________________________________________ Any additional information such as discipline, child’s communication, comforting, and so on?__________________________________________________ ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PARENT AGREEMENT
I am the parent or legal guardian of__________________________.
In order to record my understanding of my rights and responsibilities of parent, guardian or custodian of the above named child, who is enrolled in MunchkinLand PreSchool, I agree to abide by the requirements written below and all poicies set forth in the Parent Handbook.
In return for this promise of continual fullfillment of all policies, MunchkinLand agrees to provide care for the above named child which meets the standards and guidelines as set forth below and in the Parent Handbook.
The tuition fee as set forth herein will be in effect until a new agreement is signed by me. This fee will be paid in advance every other Friday as specified by the Director. I understand that my child will not be admitted without this advance payment.
I understand that a registration fee of $100.00 is due at the time of registration. Tuition payments will be made by check, money order or Tuition Express. Reciepts will be given for payments if requested. A $10.00 per day late fee will be charged to those accounts that are not paid by the Tuesday following the Friday that tuition was due.
If my child is not picked up by 5:30p.m., I agree to pay the required late pick up fee of $1.00 per minute after 5:30. I understand that I am to pay 50% of my regularly scheduled tuition when my child is gone from school for a whole week. I understand that there is a returned check fee of $25.00. Two weeks advance written notice to the Director is required when withdrawing a child from MunchkinLand. If two weeks notice is not given, I will pay two weeks from the time that notice is given.
_____________________________________
Parent/Guardian's Signature & Date
_____________________________________
Director's Signature & Date
I am the parent or legal guardian of__________________________.
In order to record my understanding of my rights and responsibilities of parent, guardian or custodian of the above named child, who is enrolled in MunchkinLand PreSchool, I agree to abide by the requirements written below and all poicies set forth in the Parent Handbook.
In return for this promise of continual fullfillment of all policies, MunchkinLand agrees to provide care for the above named child which meets the standards and guidelines as set forth below and in the Parent Handbook.
The tuition fee as set forth herein will be in effect until a new agreement is signed by me. This fee will be paid in advance every other Friday as specified by the Director. I understand that my child will not be admitted without this advance payment.
I understand that a registration fee of $100.00 is due at the time of registration. Tuition payments will be made by check, money order or Tuition Express. Reciepts will be given for payments if requested. A $10.00 per day late fee will be charged to those accounts that are not paid by the Tuesday following the Friday that tuition was due.
If my child is not picked up by 5:30p.m., I agree to pay the required late pick up fee of $1.00 per minute after 5:30. I understand that I am to pay 50% of my regularly scheduled tuition when my child is gone from school for a whole week. I understand that there is a returned check fee of $25.00. Two weeks advance written notice to the Director is required when withdrawing a child from MunchkinLand. If two weeks notice is not given, I will pay two weeks from the time that notice is given.
_____________________________________
Parent/Guardian's Signature & Date
_____________________________________
Director's Signature & Date
Permission For Health Care
Child's Name____________________________Date_______________
Child's Physician_________________________Phone_______________
Address____________________________________________
Child's Dentist__________________________Phone_______________
Address____________________________________________
AUTHORIZED ADULTS
In the event of an emergency, please indicate your name and phone number where another authorized adult can be reached.
Child's Name____________________________Date_______________
Child's Physician_________________________Phone_______________
Address____________________________________________
Child's Dentist__________________________Phone_______________
Address____________________________________________
AUTHORIZED ADULTS
In the event of an emergency, please indicate your name and phone number where another authorized adult can be reached.
